False Promises on Ovarian Cancer
Published: September 11, 2012
New evidence that women are more likely to be harmed than helped by screening tests for ovarian cancer is disturbing. The tests do nothing
to prevent healthy women from dying from the usually fatal disease. Yet
they often lead doctors to perform needless surgeries that cause
serious complications in many patients.
Related
-
Ovarian Cancer Screenings Are Not Effective, Panel Says (September 11, 2012)
Health Guide: Ovarian Cancer
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The judgment
from the United States Preventive Services Task Force, issued on
Monday, updates its longstanding verdict that healthy women with an
average risk of ovarian cancer should not be screened for the disease.
The task force, 16 federally appointed experts, makes recommendations on
which screening tests work and which don’t. The American Cancer Society
and the American Congress of Obstetricians and Gynecologists have also
discouraged the use of screening tests for ovarian cancer in most women.
Such advice does not apply to women who have genetic mutations or a
family history that puts them at high risk or to women who have
suspicious symptoms, like persistent bloating and pelvic or abdominal
pain, symptoms that are not unique to ovarian cancer.
The task force relied heavily on a large study
published last year of 78,000 women ages 55 to 74, half of whom were
screened with ultrasounds and blood tests for a biological marker of
ovarian cancer, and half of whom were not. After following them for 11
to 13 years, the death rate from ovarian cancer was the same in both
groups. But nearly 10 percent of those screened, more than 3,200 women,
had false-positive results and more than 1,000 of them had surgery,
usually to remove one or both ovaries. Many of them had serious
complications, such as surgical injuries to other organs, infections and
blood clots.
As Denise Grady pointed out in The Times
on Tuesday, the problem with the tests is that the biological marker
being measured (CA-125) can be elevated by conditions other than cancer
and the ultrasounds can reveal benign cysts that cannot be distinguished
from cancer without surgery to remove the ovary.
Despite the expert advice against routine screening, a survey
of 1,000 doctors published in February found that a third of them
believed that screening was effective and many offered it to patients.
Many patients request screening, believing that it can find the disease
early enough to save lives. It is long past time for doctors and their
patients to recognize that this assumption is wrong.
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